Individual
DR. BRADFORD JAY LOCKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1254 IRVINE BLVD, STE 260, TUSTIN, CA 92780-3586
(714) 838-0760
Mailing address
1254 IRVINE BLVD, STE 260, TUSTIN, CA 92780-3586
(714) 838-0760
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
36791
CA
Other
Enumeration date
06/01/2005
Last updated
07/08/2007
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